<form id="score-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('实付金额')}:</label>
        <div class="col-xs-12 col-sm-8">
            {$order.pay_amount}
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">退款金额</label>
        <div class="col-xs-12 col-sm-8">
            <input data-rule="required"  class="form-control" name="row[money]" type="number">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-primary btn-embossed ">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>